JOIN THE MOVEMENT
Join The 21st Century Abolitionist Movement
Thank you for your interest in becoming a 21st Century Abolitionist. We hope you will find a membership level that best fits your
desires and know you will be encourage by the bulk of work we are doing in the name of

19th Century Abolitionist Frederick Douglass
"The Father of America's Civil Rights Movement"

The Frederick Douglass Foundation encourages anyone to apply for membership. We do not discriminate based on gender,
race, class, economic status, ethnic background, sexual orientation, age, physical ability, cultural and religious backgrounds.
Please Complete The Application Below and Submit.
Credit Card Payment Can Made After Submitting Your Application
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Political Party Affiliation
Which State Chapter would you like to be affiliated with? If
your state is not listed, would you be interested in organizing
the chapter in your state?
I am interested in starting a State Chapter of the
Frederick Douglass Foundation
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MEMBERSHIP LEVELS AND BENEFITS

Membership Must Be Paid in Full To Receive Complimentary Registration and Discounts
Payment Options Available For Each Level: Complete Form and Submit to Review 12 Month Options (Credit Card Only)
Membership fees and benefits subject to change without notice.
MEMBERSHIP RENEWAL
Print Your Current Membership Number Here
HIGH SCHOOL STUDENT
Annual Dues
$10
  • $ 50 registration fee to attend the Annual Leadership Summit
  • Personalize Membership Certificate
  • Personal copy of the US Constitution
  • Member receives - quarterly e-newsletter
If you choose this membership level, you must provide the name of the high  school and city of its
location you are attending
UNDERGRADUATE STUDENT
Annual Dues
$20
  • $ 50 registration fee to attend the Annual Leadership Summit
  • Personalize Membership Certificate
  • Personal copy of the US Constitution
  • Member receives - quarterly e-newsletter
If you choose this membership level, you must provide the name of the college and city of its
location you are attending
US MILITARY VETERAN
Annual Dues
$25
  • $ 50 registration fee to attend the Annual Leadership Summit
  • Personalize Membership Certificate
  • Personal copy of the US Constitution
  • Member receives - quarterly e-newsletter
If you choose this membership level, you must indicate your Branch of service
FRIEND OF FREDERICK DOUGLASS
Annual Dues
$35
  • Personalize Membership Certificate
  • Personal copy of the US Constitution
  • Member receives - quarterly e-newsletter
21st CENTURY ABOLITIONIST
Annual Dues
$250 or Monthly Installment $25
  • In addition to the benefits above , you will receive:
  • 25% off registration to attend the Annual Leadership Summit
PLATINUM ADVOCATE
Annual Dues
$500 or Monthly Installment $45
  • In addition to the benefits above , you will receive:
  • 5 0% off registration to at tend the Annual Leadership Summit, VIP
  • Personal Invitation to attend the Annual Leadership Summit Receptions and Awards
    Banquet.
  • R ecogni zed and be listed throughout the Annual Leadership Summit
ELITE FREEDOM FIGHTER
Annual Dues
$750 or Monthly Installment $65
  • In addition to the benefits above , you will receive:
  • Complimentary registration to at tend t he Annual Leadership Summit, VIP Receptions
    and Awards Banquet.
  • R ecogni zed and be list ed throughout the A nnual L eadership S ummit
CORPORATE FREEDOM WARRIOR
Annual Dues
$1000 or Monthly Installment $85
  • In addition to the benefits, you will receive:
  • Complimentary registration for four employees to at tend t he Annual Leadership Summit,
    VIP Receptions and Awards Banquet.
  • R ecogni zed and be list ed throughout the A nnual L eadership S ummit
  • L ink to C ORPORATION website to the Frederick Douglass Foundation and affiliated
    chapter websit e s
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Copyright 2013. All content and rights are reserved by The Frederick Douglass Foundation, Inc.
Click Here to Download Your Frederick Douglass Foundation Membership Application
Print Legibly and Mail the Completed Application to
Frederick Douglass Foundation, Inc.
Attn: Member Services
PO Box 50273
Washington, DC 20091
The
Frederick Douglass Foundation
"Where justice is denied, where poverty is enforced, where ignorance prevails, and where any one class is made to feel that society is an organized conspiracy
to oppress, rob and degrade them, neither persons nor property will be safe."
- Frederick Douglass -
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